| NPI | 1104024686 |
|---|---|
| Former Legal Business Name | BOERSMA CLINIC |
| Entity Type | Organization |
| Authorized Contact | RACHEL STACK BOERSMA Owner 318-255-2733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2008-04-20 |